Individual
CHIN W. PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10601 SAN JOSE BLVD STE 117, JACKSONVILLE, FL 32257-6267
(904) 483-3027
Mailing address
10601 SAN JOSE BLVD STE 117, JACKSONVILLE, FL 32257-6267
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN23386
FL
Other
Enumeration date
06/01/2018
Last updated
06/01/2018
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